April 16, the day after Tax Day on April 15, we all breathe a sigh of relief. That’s done. One less headache for the month.

Not so fast. Here are some facts that might just cause you to keep that headache.

Less than 50 percent of severely or terminally ill patients studied had an advance directive in their medical record. Between 65 and 76 percent of physicians whose patients had an advance directive were not aware that it existed. Forty-two percent of Americans have had a friend or relative suffer from a terminal illness or coma in the last five years and for a majority of these people and 23 percent of the general public, the issue of withholding life-sustaining treatment came up.

The good news on the sixth National Healthcare Decisions Day, in 1990 only 12 percent of us had a living will, now over 29 percent do. In addition, another piece of good news, having a living will was associated with a lower probability of dying in a hospital for nursing home residents and people living in the community.

As I wrote last year, decisions about your wishes at end of life are not fun or easy. However, in 1990 with the Patient Self-determination Act, Congress affirmed the right of everyone to state his or her health care wishes in writing with an “advanced directive.” Use a wonderful resource called the Five Wishes to start the conversation.

The questions are straight forward — who makes health care decisions for me when I can’t, what type of medical treatment do I want or don’t want, how comfortable do I want to be, how do I want people to treat me and what do I want my loved ones to know?

Take control of your health care decisions; don’t let others do it for you, especially us health-care types! As a nurse, I’ve seen health care professionals impose their will on patients and families. Yet, when we are asked if we’d have the very surgery being recommended or get chemotherapy for a cancer; we are overwhelmingly saying “no.” Informed consent should be at all phases of your life, especially at end of life.

As a nurse, I was educated to be a patient advocate, as are most health care professionals. I am actively involved in my health care agency, Piedmont Health Services, Inc., in achieving Patient Centered Medical Home recognition. As a daughter of a family member with Alzheimer’s, I am working in the community with Heather McKay, Hospice Dementia Specialist and Coury O’Donoghue, executive director of Alamance House, to create a model of patient-centered dementia care. It is especially critical to have the conversation now because every 69 seconds someone is diagnosed with Alzheimer’s, One in 3 of us will have the disease.

This state has a MOST (Medical Orders for Scope of Treatment) that is a legal document for use by EMS. It clearly outlines when emergencies occur, what EMS is to do. They are trained to look for these when they come to your home or assisted living/memory center. They’re bright pink and you can’t miss them. This form along with an Advance Directive or living will, coupled with healthcare power of attorney will make clear your wishes at end of life.

Page 2 of 2 - As I shared with you last year, my family has needed this form to help make my father’s wishes known. I wish I could report that we haven’t needed it this year, but unfortunately, we’ve had two instances where it was. Did it help? Yes. Was it hard to carry out “Coach’s” game plan? Definitely. Will I keep writing this every National Healthcare Decision Day to inform and educate? You betcha.

Dr. Connie B. Bishop, of Gibsonville is director of Quality Improvement and Risk Management for Piedmont Health Services, Inc. Facts in this column came from U.S. Agency for Healthcare Research and Quality, AHRQ (2003) and Pew Research.